Unraveling the impact of kinesiophobia on proprioception and balance: Mediation by pain, mobility, and psychological wellbeing in post-total hip replacement recovery.

Abstract

This study aimed to investigate the relationships between kinesiophobia, proprioception, and limits of stability in elderly individuals post-THR. Specifically, it sought to assess the direct and indirect effects of kinesiophobia on proprioception through mediating factors such as pain intensity, functional mobility, and psychological well-being. A cross-sectional observational study was conducted with 100 participants (50 post-THR patients and 50 asymptomatic elderly controls) at King Khalid University Hospital. Kinesiophobia was measured using the Tampa Scale for Kinesiophobia (TSK), proprioception was assessed via a digital inclinometer, and limits of stability were evaluated using computerized dynamic posturography. Post-THR patients exhibited significantly higher levels of kinesiophobia (p < 0.001) and impaired proprioception (p < 0.001) compared to controls. Mediation analyses revealed that pain intensity, functional mobility, and psychological well-being partially mediated the relationship between kinesiophobia and proprioception. The Sobel tests confirmed significant mediation effects for pain intensity (Z = 3.88, p = 0.021), functional mobility (Z = 2.96, p = 0.013), and psychological well-being (Z = 2.84, p = 0.015). Kinesiophobia significantly impairs proprioception and balance in elderly individuals post-THR, with these effects being partially mediated by pain intensity, functional mobility, and psychological well-being. These findings highlight the importance of addressing psychological factors in rehabilitation programs to enhance proprioceptive function and improve postural stability, thereby optimizing recovery outcomes in the post-THR population.